Cardiovascular magnetic resonance based diagnosis of left ventricular non-compaction cardiomyopathy: impact of cine bSSFP strain analysis

Fig. 1. Retrospective Patient Identification. CMR = cardiovascular magnetic resonance; LVNC = left ventricular non-compaction cardiomyopathy; bSSFP = balanced steady-state free precession

Fig. 2. CMR Diagnostic Criteria for LVNC. a CMR short-axis cine bSSFP image of the apical LV demonstrating severely thickened myocardium with prominent trabeculations and deep intertrabecular recesses in a 49-year-old female with a history of ventricular tachycardia and LVNC phenotype. b Measurement of the maximum non-compacted (NC): compacted myocardium diameter ratio. c Standard epicardial contours and endocardial contours at the border of the compacted and NC myocardium for measurement of the compacted myocardial mass. d Endocardial contours at the border of the NC myocardium and non-trabeculated cavity for measurement of the global myocardial mass (compacted and non-compacted myocardial mass). CMR = cardiovascular magnetic resonance; LVNC = left ventricular non-compaction cardiomyopathy; bSSFP = balanced steady-state free precession; LV = left ventricle

Fig. 3. Strain: Box Plots. Box plots comparing a GRS, b GCS and c GLS between: all LVNC phenotype patients and healthy subjects; Subgroup A vs. B (LVNC phenotype patients with normal LV volumetrics and healthy subjects with normal LV volumetrics); Subgroup A vs. C (LVNC phenotype patients with normal LV volumetrics and healthy subjects with normal LV volumetrics not meeting any CMR diagnostic criteria for LVNC); Subgroup A vs. D (LVNC phenotype patients with normal LV volumetrics and healthy subjects with normal LV volumetrics meeting at least one of the CMR diagnostic criteria for LVNC); Subgroup C vs. D (healthy subjects with normal LV volumetrics meeting none of the CMR diagnostic criteria for LVNC and those meeting at least one criteria). GRS = global radial strain; GCS = global circumferential strain; GLS = global longitudinal strain; LVNC = left ventricular non-compaction cardiomyopathy; LV = left ventricle; CMR = cardiovascular magnetic resonance

Fig. 4. Strain: ROC Analysis. ROC curves for GRS, GCS and GLS comparing a All LVNC phenotype patients and healthy subjects ; b Subgroup A vs. B (LVNC phenotype patients with normal LV volumetrics and healthy subjects with normal LV volumetrics); c Subgroup A vs. C (LVNC phenotype patients with normal LV volumetrics and healthy subjects with normal LV volumetrics not meeting any CMR diagnostic criteria for LVNC); d Subgroup A vs. D (LVNC phenotype patients with normal LV volumetrics and healthy subjects with normal LV volumetrics meeting at least one of the CMR diagnostic criteria for LVNC). ROC = receiver operating characteristic; GRS = global radial strain; GCS = global circumferential strain; GLS = global longitudinal strain; LVNC = left ventricular non-compaction cardiomyopathy; LV = left ventricle; CMR = cardiovascular magnetic resonance